NPIMap

Organization Active NPI

Health Aging & Independence for All Fund Fatigue Clinic

  • Health Service Clinic/Center
  • Berkeley, CA
National Provider Identifier
1477266013
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
HEALTH AGING & INDEPENDENCE FOR ALL FUND FATIGUE CLINIC
Doing business as
Healthy Aging & Independence for All Fund Fatigue Clinic
Practice address
75 Parnassus Rd
Berkeley, CA 94708-2056
Phone
(805) 781-9111
Fax
(805) 285-4055
NPI assigned
Dec 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kourosh Bagheri, MD/MSNPI 1457540031
Title
Director
Phone
(805) 781-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

75 Parnassus Rd
Berkeley, CA 94708-2056

Mailing address

75 Parnassus Rd
Berkeley, CA 94708-2056
Phone (805) 781-9111

Other names 1

  • Healthy Aging & Independence for All Fund Fatigue Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL jackie.rambeau@gmail.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1477266013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PARNASSUS RD",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947082056",
            "telephone_number": "805-781-9111",
            "fax_number": "805-285-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PARNASSUS RD",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947082056",
            "telephone_number": "805-781-9111",
            "fax_number": "805-285-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH AGING & INDEPENDENCE FOR ALL FUND FATIGUE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-28",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "BAGHERI",
        "authorized_official_first_name": "KOUROSH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "805-781-9111",
        "authorized_official_credential": "MD/MS"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jackie.rambeau@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "170 Seacliff Dr",
            "city": "Shell Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "934491715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Healthy Aging & Independence for All Fund Fatigue Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthy Aging & Independence for All Fund Fatigue Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.